HomeMy WebLinkAboutHomestead_Rumble (2)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hc�o
State Form 5473 (R614 -03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing{rts6vctions. TT �1 T1
I (We) IF v "" certMj" or0th5 1g0% of March, 20_
I (We) occupied as o principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ i (We) owned ❑ Are buying under contract �ppyn
Have a be nefidal interest in the entity that is liable for the property taxes on the property and that G IBSON pCOUNTY /o rs Un9 L�der a contract.
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NTRACTRECORDED'��" -�'i•' "$.���s`- :a'�.�:;�'��4g'�.z r'^w�'�.x`
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
cam, y r.:n`?i'.tc.sa$zZ'i PROP, ERT, 1' sDESCRIP ,TION 5,.' <u'``3='"S'�,.
County
Township
County
Testing district (city o , to
Parcyfaprn�r
de p n
s the pro in question:
Ut // (� —�
�
ASSESSED VALUE
HOMESTEAD
property ❑ bll Homo (1.C. &/.1 -7) .
N arty portion of the residential sWCWre or the W W n exceeding one 1) acre
of the property utiraed to produce income.
a immediatety surrounds that sW a is used b produce incom ,describe the use and portion
`Township
County
Township
County
1 hereby certify the above statements are We, correct and complete.
Si nat a of c imant
PjdZliress (number and street, crty, state, ZIP code)
as yje.
°' '' -'
yy ASSESSOR USE ONLY �">
�_.. �r�. .'s..ro`.. `F'VAI.UEAT.�100Y.,OFTTVVALUE
w TRUE-,TAX —
�
ASSESSED VALUE
HOMESTEAD
� :
- NON=RESIDENTIAL e
.fit .,`'rVAI:UE.;,a.
Land not exceeding 1 (one) acre immediately
surrounding esidential improvements.
9 DK
(1)
Datei
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- '"
Other land
(2)
WHO.7
Total land (line 1 plus line 2)
(3)
'Residential improvements or Annually
Assessed Mobile / Manufactured Home
Dwelling
Garage
(4)
��� f -~� 01
¢- SIR s G'•'
s
Other improvements
(6)r
Total improvements (line 4 through line 6)
(7)
Total value (tine 3 plus line 7)
(6)
1 hereby certify the above is We, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
6ARD' DEDUCTION'ALCOWANCE-'- P. •—
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20 _ Pay 20
Lesser of 112 Homestead
$
Valuation er .000
S"
Datei
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